{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T21:43:28Z","timestamp":1757540608048,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the interactions between cervical length (CL) and placenta accreta spectrum (PAS) on severe postpartum hemorrhage (SPPH) in patients with placenta previa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective case\u2013control study was conducted at four medical centers in China, and 588 patients with placenta previa were included. The logistic regression analysis and restricted cubic splines (RCS) were used to evaluate the association between CL and SPPH. Furthermore, the joint effect of CL and PAS on SPPH was assessed, and the additive and multiplicative interactions were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After adjusting for potential confounders, the negative linear dose\u2013response relationship was confirmed by RCS, and the change of odds ratio (OR) was more significant when CL was 2.5\u00a0cm or less. The risk of SPPH was significantly higher when CL of 2.5\u00a0cm or less co\u2010existed with placenta increta\/percreta than when CL of 2.5\u00a0cm less, or placenta increta\/percreta existed alone (adjusted OR [aOR]<jats:sub>CL\u2009\u22642.5cm&amp;placenta accreta\/non\u2010PAS<\/jats:sub>3.40, 95% confidence interval [CI] 1.37\u20138.45; aOR<jats:sub>placenta increta\/percreta&amp;CL\u2009&gt;2.5cm<\/jats:sub>4.75, 95% CI 3.03\u20137.47; aOR<jats:sub>CL\u2009\u22642.5cm&amp;placenta increta\/percreta<\/jats:sub>14.51, 95% CI 6.08\u201334.64), and there might be additive interaction between CL and placenta increta\/percreta on SPPH (attributable proportion due to interaction 50.7%, 95% CI 6.1%\u201395.3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>If CL was routinely performed during PAS evaluation, the increased OR of short CL and PAS could allow better patient preparation through counseling.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14641","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T00:20:50Z","timestamp":1672100450000},"page":"1069-1074","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Interactions between ultrasonographic cervical length and placenta accreta spectrum on severe postpartum hemorrhage in women with placenta previa"],"prefix":"10.1002","volume":"161","author":[{"given":"Xiaohe","family":"Dang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cuifang","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Renmin Hospital of Wuhan University Wuhan 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